Healthcare Provider Details

I. General information

NPI: 1427358696
Provider Name (Legal Business Name): CHRIS LAWRENCE AND ASSOCIATES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W BROADWAY BLDG 2, SUITE F
COLUMBIA MO
65203-3842
US

IV. Provider business mailing address

201 W BROADWAY BLDG 2, SUITE F
COLUMBIA MO
65203-3842
US

V. Phone/Fax

Practice location:
  • Phone: 573-214-0436
  • Fax: 573-442-0606
Mailing address:
  • Phone: 573-214-0436
  • Fax: 573-442-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2010018200
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY01793
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2003027880
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2009031585
License Number StateMO

VIII. Authorized Official

Name: KIM BOWMAN
Title or Position: HR
Credential:
Phone: 573-214-0436